Association of Social Support With Complicated Grief and Post-Traumatic Stress Symptoms Among Student Survivors of the Sewol Ferry Disaster: An Observational Longitudinal Study.

BACKGROUND

This longitudinal study examined how social support has interacted with complicated grief and post-traumatic stress disorder (PTSD) symptoms among student survivors of the Sewol ferry disaster.

METHODS

Sixty-six student survivors were recruited and evaluated biannually from 2016 to 2021. Duke-UNC Functional Social Support Questionnaire, PTSD Checklist for Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, and Inventory of Complicated Grief were used for data collection. Demographic data were treated as covariates. Group-based trajectory modeling delineated longitudinal trajectories of social support, and a series of generalized estimating equation models compared elevated PTSD symptoms and probable complicated grief among the identified trajectory groups.

RESULTS

A four-group solution for trajectories of social support was the optimal model (group 1, low baseline social support; group 2, moderate baseline support increasing over time; group 3, high baseline support; group 4, highest baseline support). Compared to trajectory group 4, trajectory group 2 had a significantly higher risk for elevated PTSD symptoms, while trajectory groups 1 and 2 had a significantly higher risk for probable complicated grief.

CONCLUSION

Our study highlights the importance of social support and its changes relating to psychopathology including complicated grief and PTSD symptoms after disaster exposure. Individuals sensitive to changes in the level of social support who also have relatively low initial support may be particularly vulnerable.